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Assessing nursing and midwifery applicants who have not practised for a period of five to ten years

The Nursing and Midwifery Board of Australia (National Board or NMBA) has approved this framework for assessing nursing and midwifery applicants for re-entry to practice. The framework is an interim guideline for:

applicants seeking to re-enter the nursing and/or midwifery professions after a five (5) to 10-year period of not practising, and

assessors of those applications

The framework is part of suite of guideline documents currently under development for applicants for re-registration. When the documents are complete, the NMBA will consult on them with key stakeholders.

The purpose of the framework is to help determine the appropriate NMBA-approved pathway of re-entry, which is either supervised practice or a re-entry to practice program.

In accordance with the Health Practitioner Regulation National Law as in force in each state and territory (the National Law), the Nursing and Midwifery Board of Australia (National Board or NMBA) has approved a number of registration standards, two of which are the Recency of practice and the Continuing professional development (CPD) registration standards for nurses and midwives.

The NMBA Recency of practice registration standard applies to all nurses and midwives when they apply for renewal of registration each year. Previously registered nurses and midwives in Australia who have not practised in their respective profession for a period of between five (5) and 10 years will be required to undergo an individual assessment of their application. The Re-entry to practice policy (implemented on 19 March 2012) was developed to set out the processes to be followed when nurses and/or midwives do not meet the re-entry to practice requirements.

It is the relevant state or territory board or registration committee of the NMBA that, on the merits of each case, makes individual decisions about whether a person applying for re-entry to the profession who has not practised for a period of between five and ten years needs to be directed to either:

a Board-approved period of supervised practice or

a Board-approved re-entry to practice program.

However, as part of the policy implementation and to assist with national consistency, the NMBA undertook to develop a set of principles to assist the decision-making of state and territory boards and registration committees. These principles incorporate consideration of three key elements – professional competence, confidence and capability. The main underlying principle for re-entry decisions is the safety of the health practitioners to practise in the profession.

This document elaborates the principles that underpin re-entry decisions. It is focused solely on assisting determinations for applicants who have not practised for a period of time between five and ten years. It is based on three considerations: the individual, their experience in the preceding five to ten years, and their plans for the future. These three considerations should be looked at as a whole, not judged in isolation. The document includes an explanation of the principle and the type of evidence that might assist in demonstrating the principle (see Table 1). It also provides a case study/exemplar for each end of the spectrum.

Table 1:

Principles for determining whether an applicant who has not practised for five (5) to 10 years ought to undertake either a NMBA- approved period of supervised practice or a re-entry to practice program

Time line out of practice

Principle

Content of principle

Evidence of principle

Up to 5 years

Meets registration standard

5 to 10 years

The individual

Extent of relevant nursing and/or midwifery practice

Extent of nursing and/or midwifery post graduate education

Extent of nursing and/or midwifery Continuing Professional Development

Ability to meet relevant nursing and/or midwifery competencies

Documentary evidence of practice providing evidence of consolidation of practice using the relevant competency standards

Documentary evidence of post graduate qualifications

Documentary evidence of Continuing Professional Development in nursing and/or midwifery

Portfolio prepared to demonstrate ability to meet all relevant nursing and/or midwifery competencies which may include documentary evidence above.

The individual may make a submission to demonstrate how their Continuing Professional Development and work undertaken is relevant to their application.

Documentary evidence of any relevant experience as defined above.

Plans for future professional practice

Reasons for desire to re-enter the profession/s.

Plan for re-entry in terms of knowledge and forethought about contemporary practice in the profession/s today.

Indication of plans for future professional practice.

Accompanying submission to address the three principles.

Provide evidence of employment offer where available.

Greater than 10 years

Complete requisite studies within a National Board approved entry to practice program of study leading to initial registration, as identified by a NMBA approved education provider following recognition of the individual’s prior learning.

The NMBA considers that applicants who have not practised for a period of time between five and ten years will sit along a continuum. At one end of the spectrum will be those who appear to have maintained competence and are probably safe, and thus will simply need to demonstrate this fact through supervised practice; and at the other end of the spectrum will be those who are not able to demonstrate that they have maintained competence and thus for safety will need to undertake a NMBA-approved re-entry to practice program to re-establish and confirm competence.

It is important to note that supervised practice and re-entry to practice programs cannot be considered equivalent to each other. The NMBA is of the view that an applicant must likely be safe in order to undertake supervised practice. Supervised practice is intended to consolidate and confirm existing knowledge; if it is determined that the applicant has insufficient current knowledge they should be directed to complete a re-entry to practice program.

Supervised practice means a period of practice under direct supervision, equivalent to the minimum amount of practice required to demonstrate recency of practice (three months’ full-time equivalent). Where supervised practice is required, it is the responsibility of the applicant to arrange a placement that meets the requirements of the NMBA.

Supervised practice must take place in a health setting that provides clinical experience placements for education providers delivering Board-approved programs of study leading to registration as a nurse or midwife.

Re-entry to practice program means a program of study accredited by the Australian Nursing and Midwifery Accreditation Council (ANMAC), and approved by the NMBA. It prepares nurses and midwives for re-entry to the register after a lapse in practice for a period exceeding the requirement in the Recency of practice registration standard. It contains both a theoretical and a clinical experience component.